围孕期危险因素暴露与先天性心脏病发病的临床流行病学观察  

Clinical epidemiological study of peri-conceptional multiple risk factors and congenital heart diseases

作　　者：陈晓媛[1,2] 胡劼[3] 王锦[2] 马慧[2] 白炜[2] 刘珍[2] 张华[2] 徐辉[2] 苏海砾[2] 

机构地区：[1]第四军医大学西京医院超声科西安,710032 [2]陕西省延安大学附属医院超声科 [3]新疆医科大学附属中医医院超声科

出　　处：《中华医学杂志》2015年第9期701-704,共4页National Medical Journal of China

摘　　要：目的 探讨围孕期多种危险因素暴露与先天性心脏病的发病之间的相关性.方法 选择2012年3月1日至2013年10月1日在第四军医大学进行超声心动图检查确诊为先天性心脏病的435例（患病组）幼儿及574例（健康对照组）正常体检的儿童家庭作为观察对象,对其家庭一般情况及围孕期有毒环境因素暴露情况进行问卷调查.对采集的数据予以数量化和分级,输入SPSS 13.0数据库,经逻辑校对无误后应用x2检验,非条件Logistic回归分析方法进行资料分析.结果 患病组幼儿体质量低于健康对照组（P＜0.01）,但两组受检者在年龄、身高、心率及父母年龄方面差异均无统计学意义.父母的受教育程度在先天性心脏病患病组与健康对照组之间差异有统计学意义（P＜0.0t）,且先天性心脏病组中父亲及母亲高中及以下受教育程度的比例明显高于健康对照组（父亲：86.7％比67.4％,母亲：83.4％比66.4％）.圆锥干畸形和单纯室间隔缺损是发病率最高的先天性心脏病.药物、工作环境暴露和病毒性感染均与圆锥干畸形有很高的相关性（P＜0.01,OR值分别为6.74、3.73、2.82）.药物、病毒感染、房屋装修、烫发染发及工作环境暴露均会增加单纯室间隔缺损的罹患风险（OR值分别为2.77、2.07、1.76、1.89、1.81）.结论 围孕期多种危险因素暴露与先天性心脏病发病存在显著的相关关系.Objective To evaluate the associations between the occurrence of congenital heart diseases （CHDs） in children and exposures to peri-conceptional multiple nongenetic risk factors.Methods For this age-matched case-control study,standardized data were collected from 435 families of children with CHD and 574 families of non-malformed children.The questionnaires were conducted on multiple nongenetic risk factors including paternal characteristics and conditions,maternal therapeutic drug exposure,housing renovation,hair perming and dyeing and parental occupational exposure.Results The CHD infants weighed less than control group （P 〈 0.01）.However two groups had no significant differences in age,height,parental age or heart rate.Educational levels of parents had a negative correlation with CHD.Conotruncal defect and simple ventricular septum defect were the most common cardiac abnormalities.Therapeutic drug exposure,viral infection and occupational exposure all had a high level of correlation with conotruncal defect （OR =6.74,OR =3.73,OR =2.82 respectively）.And ventricular septum defect was associated with therapeutic drug exposure,home decoration,hair perming and dyeing and parental exposure of work environment （OR =2.77,OR =1.76,OR =1.89 respectively）.Conclusion Multiple nongenetic risk factors may contribute to the occurrence of CHD.

关 键 词：心脏病 危险因素 流行病学 

分 类 号：R725.4[医药卫生—儿科]